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Individual

ASHLYN LOUISE DEEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1111 S 1350 W, OREM, UT 84058-3817
(801) 935-4171
Mailing address
150 E 700 N APT 10, PROVO, UT 84606-2701
(480) 494-6838

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A21382530
AZ
Enumeration date
04/10/2019
Last updated
04/10/2019
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